Perioperative Anemia Management in Patients Undergoing Gynaecologic Procedures: A 12-Year Multisite Study

Area of Science:

• Anesthesiology
• Hematology
• Gynecologic Surgery

Background:

• Perioperative anemia is a significant risk factor for adverse surgical outcomes.
• Effective management of anemia and blood transfusions is critical in surgical patient care.

Purpose of the Study:

• To characterize red blood cell (RBC) transfusion and intravenous (IV) iron use in patients undergoing gynecologic procedures.
• To assess the incidence of perioperative anemia and its association with clinical outcomes.

Main Methods:

• Retrospective cohort study utilizing a multihospital database in Ontario, Canada.
• Identified patients (≥15 years) undergoing gynecologic surgery between April 2010 and March 2022.
• Primary outcomes: perioperative RBC transfusion and IV iron utilization; Secondary outcomes: length of stay, ICU admission, mortality.

Main Results:

• 27.6% of patients had preoperative anemia; 18.7% received perioperative RBC transfusion.
• Patients with malignancy had higher RBC transfusion rates (29.7%) compared to those without (7.8%).
• Preoperative anemia correlated with increased ICU admissions and hospital length of stay, especially in patients with hemoglobin <80 g/L.

Conclusions:

• Preoperative anemia is prevalent in gynecologic surgery patients and associated with adverse clinical outcomes.
• The study underscores the necessity of institutional patient blood management programs.
• Optimizing anemia management can potentially improve surgical outcomes and reduce healthcare utilization.